As of the July, 2022, release via CMS

CONNALLY MEMORIAL MEDICAL CENTER

CMS id: 450108
499 10TH STREET, FLORESVILLE TX 78114. County: WILSON
System: --
CBSA: San Antonio-New Braunfels, TX

The 44-bed, acute-care hospital had $-4,373,269 in net service to patients*, with a total profit margin of 10.32441% in fiscal year 2021, the latest year available.
It spent 6.88% of its operating expenses on uncompensated care and reported $0 in Medicaid shortfall.

* For more about Net Service to Patients and operating revenue, please the finance section below.

Note: Medians are from acute-care hospitals with "complete" fiscal years. For more about how we calculated medians and cost reports in general, please click here.

Details

	2017	2018	2019	2020	2021
# of days in fyear	365	365	365	366	365
Ownership	gov	gov	gov	gov	gov
Acute beds Median	40 118	40 118	40 119.5	40 118	40 119
Total beds Median	44 162	44 162	44 162	44 162	44 163.5
FTEs Median	253.88 788.06	244.62 793.42	262.14 806.03	244.73 787.61	241.49 804.34

Finances As they appear in worksheet G3 of the cost reports.

Note: Net Patient Revenue is considered operating revenue, which means Net Service to Patients is considered operating profit. Click here for more about cost report financials

Hospital cost reports are an enormously complicated dataset. There are whole organizations and an offical CMS vendor dedicated to helping researchers work with the data.
It's important to understand that hospital financials in cost reports are not organized in the same as other sources such as annual financial reports to bond holders.

The biggest difference is the concept of operating revenue and profit. Net Service to patients (NS2P), which is the sum of net patient revenue minus operating expenses, is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

That would make Net Patient Revenue = operating revenue.

All this makes things challenging when comparing what's reported in cost reports to other sources. It becomes clearer when you consider that, beyond the purpose of reimbursement, cost reports are a tool for policymakers trying to understand the financial situation of a hospital doing the tasks specific to hospitals.

In other words, while a facility with a division that formulates drugs might include earnings from that as operating revenue in their corporate annual result, this is not central to the operations of a hospital caring for patients and so it is counted as "other income." (See below the financials section for more on "other income")

The healthcare consulting firm HMP, in a former partnership with Modern Healthcare, did develop a formula for estimating operating revenue closer to what one might find in other sources. We no longer use this for the following reasons:

The measure was not widely used beyond HMP and Modern Healthcare. Many hospitals had their own internal estimates of operating revenue and profit.
Because of this, there was confusion when reporting operating results for individual hospitals. There was often pushback when a facility's internal numbers did not match what Modern Healthcare was reporting.
The formula includes revenue from portions of the "other income" section, which may also include non-operating revenue. HMP themselves point out in a caveat on their site that they cannot exclude all non-operating revenue from their measure.

HMP's operating measure has proven problematic in the past for our reporting and the partnership with them ended years ago. It's best to not use a measure that we alone cannot defend.

	2017	2018	2019	2020	2021
Net patient revenue ? Median	33,612,927 150,932,746	32,754,267 158,950,878	34,564,256 168,696,998	32,912,580 163,454,693	36,210,475 186,589,412
Operating expenses Median	38,768,486 149,311,209	37,105,944 156,110,414	37,593,975 164,890,568	38,115,685 166,516,854	40,583,744 180,120,888
Net income from service 2 patients (NS2P) ? Median	-5,155,559 -964,173	-4,351,677 -643,601.5	-3,029,719 -116,254	-5,203,105 -5,025,862	-4,373,269 -1,284,564
NS2P margin ? Median	-15.34% -0.62	-13.29% -0.29	-8.77% 0.18	-15.81% -5.07	-12.08% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CONNALLY MEMORIAL MEDICAL CENTER compared to all** acute-care hospitals, from CMS cost reports.
Note: NS2P is considered operating margin by MACPAC. The chart below is interactive: click or touch to see more.

* Data range does not show outliers, which fall beyond the minimum and maximum of the range.
** From cost reports with complete fiscal years. Number of acute-care hospitals available to calculate medians:

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

	2017	2018	2019	2020	2021
Other income* Median Click here to show/hide details	6,029,426 5,089,215	5,813,620 4,572,541	5,541,665 5,268,134	6,562,567 13,092,619	9,145,009 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	62,074 224,999	89,778 199,009	72,036 206,870.5	104,077 194,343	42,283 249,496
⊳ Line 7: Investments ? ⊳ Median	20,074 299,524	96,579 188,688.5	138,317 370,813	98,599 309,361.5	7,880 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	34	15	18	21	24
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	102,978	95,364	97,383	76,699	62,016
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	17,514	14,460	13,789	12,740	16,294
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	2,092	2,400	2,400	1,000	400
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	19,177	85,886	134,743	59,377	49,523
⊳ Line 23: Gov appropriations ? ⊳ Median	3,088,982 1,017,693	3,644,908 983,261.5	3,809,162 1,173,286	4,108,249 1,987,202	4,429,665 1,597,664
⊳ Sum Line 24	2,716,501	1,784,230	1,273,817	2,101,805	4,536,924
Total income ? Median	873,867 6,586,430	1,461,943 6,767,106	2,511,946 8,419,950	1,359,462 8,094,175	4,771,740 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	63,133 89,880.5	0 106,761	89,055 31,473.5
Net income Median	873,867 6,043,842	1,461,943 5,845,112	2,448,813 7,606,259	1,359,462 7,283,041	4,682,685 14,957,241
Net margin Median	2.20438% 4.62%	3.79057% 4.42%	6.10586% 5.16%	3.44384% 5.2%	10.32441% 9.25%

* About "Other income": Other income, or line 25 in worksheet G3, is the sum of lines 6 through 24. It includes three lines that are considered non-operating revenue - contributions, investments and government appropriations. Medians are included for these three lines. It also contains items that are not central to providing healthcare, such as revenue from parking or gift shops.
"Sum Line 24" is a special case. Called "Other (specify)" in the cost reports, CMS allows for this line to be "subscripted," or divided into sublines like 002400, 002401, 002402. And hospitals do that, up to 100 lines, to detail income (and sometimes negative returns) that are otherwise not covered in the previous "other" lines. Therefore, "Sum Line 24" is the sum of all the lines 24.

Range* of total profit (loss) margins

= Total margin for CONNALLY MEMORIAL MEDICAL CENTER compared to all** acute-care hospitals, from CMS cost reports.
The chart below is interactive: click or touch to see more.

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

Medicare revenue

Inpatient and outpatient revenue

	2017	2018	2019	2020	2021
All inpatient revenue Median Click here to show/hide details	3,066,934 23,241,334	2,616,966 23,709,545	2,580,519 24,248,380	2,340,407 22,858,541	2,323,652 23,620,613
"All inpatient revenue" is made up of any Medicare payments for routine inpatient, swingbed SNFs, TEFRA, IPF, IRF, inpatient long-term care, CAH and inpatient SNF facilities. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine inpatient revenue ⊳ Median	3,066,934 21,577,146	2,616,966 22,041,594	2,580,519 22,722,063	2,340,407 21,570,441	2,323,652 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Inpatient psychiatric facility (IPF) ⊳ Median	0 1,845,420	0 1,757,392	0 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	0 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Critical-access hospitals ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Skilled-nursing facilities (SNF) ⊳ Median	0 1,203,033	0 1,215,295	0 1,313,657	0 1,365,298	0 1,179,746
All outpatient revenue Median Click here to show/hide details	3,983,413 11,160,864	3,985,717 11,987,345	4,001,100 12,926,866	3,971,589 11,884,480	4,453,394 13,145,163
"All outpatient revenue" is made up of any payments for routine outpatient, HHA, CMHC, rural health and other federally-qualified health clinics. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine outpatient revenue ⊳ Median	3,016,710 10,918,923	3,085,174 11,706,976	2,962,867 12,615,917	3,032,403 11,458,116	3,456,214 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	653,318 1,282,808	562,344 1,407,728	639,560 1,341,512	553,203 1,407,046	453,302 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	313,385 618,038	338,199 697,279	398,673 690,232	385,983 684,010	543,878 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	0 3,284,314	0 3,250,551	0 3,386,837	0 3,360,806	0 3,508,953
Disproportionate-share hospital (DSH) Median	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	73,638 582,572	7,071 538,116	11,695 212,434	34,787 126,559	27,985 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	305,867 2,654,636	1,494,486 2,940,659	1,229,184 3,380,215	810,776 3,488,738	1,510,823 3,233,405
Uncompensated care (UCC) Median	2,494,067 5,147,790	2,969,869 5,337,617	3,127,887 5,711,082	1,542,294 5,923,418	2,790,593 5,508,107
UCC as a % of operating expenses Median	6.43% 3.24	8.00% 3.12	8.32% 3.21	4.05% 3.3	6.88% 2.86
Total shortfall/UCC Median	2,494,067 9,489,989	2,969,869 9,424,297	3,127,887 10,120,158	1,542,294 11,171,337	2,790,593 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	13,110,187 52,142,039	15,262,632 54,485,252	16,386,841 57,395,589	16,347,824 58,830,919	17,172,129 61,722,907
Salaries as a % of operating expenses Median	33.82 36.68	41.13 36.56	43.59 36.37	42.89 35.93	42.31 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	0 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	0 1,469,317
Contract adjusted salaries, direct-care Median	61,002 1,449,244	44,698 1,475,986	137,718 1,563,078	161,949 1,721,954	774,493 2,991,828
Contract hours, direct-care Median	959.13 22,725	705.70 23,018.5	2,226.79 24,503.48	2,725.32 25,026.5	8,390.37 33,786
Contract wages, direct-care Median	63.60 64.67	63.34 64.53	61.85 65.06	59.42 68.97	92.31 88.94

* in an approved program

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Cost reports are self-reported by the facility, are subject to revision and should be considered preliminary.

* Net Service to patients (NS2P) equals net patient revenue minus operating expenses. NS2P is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

About medians

Medians are calculated from reports with "complete" fiscal years, or reports with fiscal years of at least 300 days and no more than 420 days.

In cases where there are fewer than 50 values reported, medians are not calculated. For childrens' hospitals, it's when fewer than 20 are reported.

Web app by Tim Broderick | email.